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The Care
Management Process |
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Enrollment/Assessment |
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ForeSee Health utilizes a team approach for the provision
of care management services for participants identified as high-risk.
ForeSee Health’s RN Care Managers, Care Assistants (providing administrative
support to Care Managers), Medical Director, and the participant’s
physician work together in support of the high-risk participant. |
RN Care Managers contact high-risk participants to
collect in-depth information about health status, functional level, risk
factors, barriers and willingness to change, psychological needs, and
social support structure. Care Managers complete a telephone assessment
with all newly identified high-risk members. The assessment seeks to:
- Confirm the diagnosis and attain agreement from
the participant to participate in the program;
- Determine the level of practical knowledge the
participant has about his/her condition;
- Refine acuity level by understanding participant’s
ER/hospital use, frequency of provider office visits and amount of
missed school or work;
- Document medication use;
- Ascertain whether or not participant has other
conditions or complications;
- Determine the participant’s barriers and readiness
for change, since optimal management of chronic conditions is achieved
through from positive behavior change and lifestyle modification; and,
- Determine what barriers, if any, exist (social,
financial, emotional) that need to be taken into consideration for
successful care management.
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